PAE and the search for answers

Posted , 12 users are following.

Hello,

They tell you it's natural to have BPH. But in my late 40's it didn't feel natural at all and a lot of men just don't get BPH. So like a lot of you, I started an internet quest for information. I researched BPH treatments for at least 10 years or so concentrating on non invasive treatments. My Uro told me he could do Green Light laser and that it could cause RE but said "it's no big deal"... I looked up RE (retrograde ejaculation) and was stunned... How in the hell is that no big deal? No big deal for him. He's seeing dollar signs and cant wait to bill my insurance for thousands... I decided to look at non invasive procedures. I spent a lot of time looking into the Gat-Goren method for treating BPH which still seems to be the real cure to me. But, there is something mysterious about the why their "cure" hasn't spread world wide. They basically found that BPH is caused by one or more varicoceles in the veins of the system leading to the prostate. This causes a back-flow of testosterone into the prostate , something like 10,000 times too much, basically bathing it in testosterone and causing BPH. They basically fix the varicocele's by embolizing them and that's it. The prostate gradually goes back to it's normal size. There are many people around the world who've had it done including the Israeli prime minister. I assumed when I first heard of it that it wouldn't take long for it to be "the" cure for BPH and it would spread around the world. That never happened. I believe they still do the procedure but it costs somewhere around 25 thousand US. I have no idea why this procedure has stalled as far as being adopted world wide. Maybe it's all a hoax? I don't think so but there's other factors involved I guess. While I was looking at Gat-Goren, I started to look into PAE. I watched for a few years as the studies came in. In the meantime my BPH was getting worse. My flow test(forgot the proper name) was not good... I think the score was an 8. My uro said I was peeing like and an 80 year old man. I was also retaining urine. But my prostate wasn't massive like other guys. It was around 55 grams. I had to dehydrate myself before going to bed to make it 6 hours which I could do once and a while. I had to usually get up twice a night. I know a lot of you have it much worse. I didn't want to take any drugs though. Things started to get worse . I called Dr. Bagla about a year and a half ago and talked about the PAE procedure. I made a date. What I like about PAE was the noninvasive factor and the fact that it doesn't preclude you from getting other procedures in the future(Gat-Goren?) and it can be repeated. The side effects are minimal to none. I postponed the procedure after reading that patients could be exposed to too much radiation. I called Dr. Bagla and read up on it. It turns out the radiation is minimal. I think a lot of urologist spread disinformation about PAE. Anyway, I had it done 5 weeks ago(at age 56) and all is good. Peeing very strong, no stops and starts....holding it better and it's supposed to improve even more for the next few months. Turns out my prostate was only 50 grams. Twice normal size but not as large as a lot of guys on these threads. I think the success rate is slightly better with smaller prostates. I read of a lot of treaments on this thread and I wonder why would you go with a procedure where you have something put up your penis and manipulated and take a chance of getting RE and a lot of other side effects when you could have PAE done first? PAE should be the first line of treatment for most of you and probably would be the last. I wouldn't let a urologist go near my penis unless I was half dead. I understand the hesitation to do anything when it comes to ones private parts. I won't go into PAE details here. There's been a lot written about it in these threads and there's a ton of info online about it. Don't let a urologist talk you into something. Do your research and make the right decision. Good luck.

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  • Posted

    Wow - so sorry to hear about your experience Tom- Yes i have never heard of or read of sexual side effects. IR Docs talk about other organs but never nerves that affect erection. These are below the prostate as i understand.

    Was your IR doc experienced? Did he use spinning CT scan to track blood flow.

    My Doc says he would use this to make sure to get correct blood supply

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    • Posted

      My IR doc is the head of the IR dept and I thought he did a very good job. The lack of success is likely due to some median lobe and possible bladder outlet obstruction issues. The sexual side effect was never mentioned in anything I read prior to having the PAE. I believe I read all papers about PAE available on the net, and had many discussions about it here on this forum. So, how was I or anyone else to know? I have no idea what type of CT scanner he used. The equipment seemed to be state of the art. If others here have had the PAE procedure and have not experienced any change in erections, then my issue might be related to something else. I did have radiation to the prostate for prostate cancer four years ago (successful), but was still able to have erections until the PAE. The prostate is at the center of many vital processes - urination and sex are critical quality of life issues. So, anytime the prostate is radiated, heated, frozen, cut, or starved for blood some side effects are likely to occur and may be serious. I can't think of any procedure that has been previously discussed here that hasn't been regretted by some of our participants.

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    • Posted

      Let's try again - did you go thru the entire set of urodynamics or not? It's a croc that a uro would say to you, "well, you must have some tight bladder issues" Urodynamics would CLEARLY show this. Based on what you have been saying, I'd wager a ton that these tests were not done.

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    • Posted

      Tom

      I am praying for you and sending you good vibes.

      Thanks for sharing- and you are correct no procedure is flawless

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    • Posted

      You are absolutely correct - my uro did NOT have me do the urodynamics tests and has never suggested it. Earlier this year I was discussing with him the various options since the PAE wasn't helping me, and he said he wouldn't move forward with anything until he did a cystoscopy. This was done - gave me a UTI.

      I told him that previously I was told I had a median lobe by another urologist in his department, and after the cystoscopy he said I didn't have a median lobe issue. If that's true then perhaps the PAE DID reduce the prostate and solved the median lobe issue. Who knows? He told me that any procedure he might do (full or modified TURP) might not work, so he sent me to the nurse who does the pelvic floor exercises. She also did some massage of the bladder muscles. My uro never did come straight out and say I had bladder obstruction. I was going to suggest urodynamics on my own but he gets very irritated with me when I second guess him. How dare the patient tell the surgeon what to do!!!

      At this point I have had it with these guys and the whole process of evaluation and treatment of prostate/bladder issues. I would think that there would be a standard way of evaluating the cause of the weak flow issues - testing, imaging etc. Then, based on the findings, a clear and rational way to move forward. From what I can tell, it all depends on which uro you happen to go to - they all appear to have their own ways of doing things and their own treatment specialties. So, it's up to the patient to figure all of this out, as I have been trying to do for several years.

      I am very thankful for all on this forum who do their best to give good advice. Thank you!!!!

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    • Posted

      spr,

      My sincerest thanks for your prayers and good vibes. So many good people on this forum....

      Tom

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  • Posted

    Hi TGT111

    What is the latest ? Everything going well? I am wondering if I should make an appointment with Dr. Bagla.

    Thanks for the info

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